Cholinesterase Inhibitor (Includes Enlon-Plus) ↔ Bradycardia

Severe Potential Hazard, High plausibility

Applies to: Arrhythmias, Heart Block

Due to their pharmacological action, cholinesterase inhibitors can have a vagotonic effect on the sinoatrial and atrioventricular nodes producing bradycardia or heart block. Therapy with cholinesterase inhibitors should be administered cautiously in patients with preexisting bradycardia or underlying cardiac conduction abnormalities. Syncopal episodes have been reported in patients with and without cardiac abnormalities. Atropine may be used to reverse bradycardia produced by cholinesterase inhibitors.

Cholinesterase Inhibitor (Includes Enlon-Plus) ↔ Bronchospasm

Severe Potential Hazard, High plausibility

Applies to: Chronic Obstructive Pulmonary Disease, Asthma

Cholinesterase inhibitors inhibit the hydrolysis of acetylcholine. The enhanced effect of acetylcholine produces constriction of the bronchi, increased bronchial secretions, and bronchospasm. Therapy with cholinesterase inhibitors should be administered cautiously in patients with respiratory dysfunction, history of asthma or obstructive pulmonary disease. Monitoring respiratory function during dosage initiation and adjustment are recommended. Use of atropine along with discontinuation of the cholinesterase inhibitor may be required for serious respiratory distress. Neostigmine may produce more severe muscarinic side effects than does pyridostigmine and ambenonium. However, the duration of action is longest for ambenonium and shortest for edrophonium. Echothiophate iodide ophthalmic may be systemically absorbed and cautious use is recommended in these patients.

Cholinesterase Inhibitor (Includes Enlon-Plus) ↔ Parkinsonism

Severe Potential Hazard, High plausibility

Applies to: Parkinsonism

Cholinesterase inhibitors should be used with caution in patients with parkinsonism. Some of these drugs might be contraindicated in these patients (refer to specific prescribing information). Symptoms of Parkinson's disease may be exacerbated with the increase in cholinergic activity. Caregivers and patients should be advised.

Cholinesterase Inhibitor (Includes Enlon-Plus) ↔ Pud

Severe Potential Hazard, High plausibility

Applies to: Peptic Ulcer

The use of cholinesterase inhibitors is associated with an increase in gastric acid secretion and gastric contractions. Therapy with cholinesterase inhibitors should be administered cautiously in patients with peptic ulcer disease.

Do not stop taking any medications without consulting your healthcare provider.

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